AIDS: Who is opposing condom use?

Speech by Keith Porteous Wood of the (UK) National Secular Society

Given to a joint congress of the International Humanist and Ethical Union and American Humanist Association in Washington DC on 6 June 2008

It is an honor to address you today.

Those on the religious right wanting to interfere in HIV/AIDS prevention policy were understandably delighted with the election of George W Bush. It gave them the opportunity to ignore the evidence on HIV/AIDS prevention, and to replace science with pseudo-science, and facts with faith.

Opposition to condoms as a tool to fight the spread of HIV/AIDS is motivated primarily by conservative religious ideas.

Whether the religious right’s campaign is flagrant dishonesty or simply being blinded by religious dogma, I’ll leave to you to decide, but – either way - the effects are just as devastating.

In 1999, Bush told a crowd in New Hampshire [1]
My Administration will elevate abstinence education from an afterthought to an urgent goal,"

In Indianapolis, he promised,
"In every instance where my Administration sees a responsibility to help people, we will look first to faith-based organizations, charities and community groups [2]

Now, under pressure from the religious right, the US Government has ring-fenced a third of the country’s contribution to international AIDS prevention what they call “abstinence programs”, even though such programs on their own are condemned by practitioners in the field as insufficient.[3]

More disgracefully, religious campaigners are using fake science, and even lying about real science. Why? To cover up their religious motivation.

In 2004, The New York Times blew the whistle on the disinformation spread by Randall Tobias, the AIDS coordinator for the Bush Administration. [4] He had asserted on numerous occasions that condoms are not effective at preventing the spread of AIDS in the general population.

He even cited a report from the London School of Hygiene and Tropical Medicine supposedly supporting this claim when testifying in the House of Representatives.

But this was not true. The Dean of the London School wrote to him to say that the School had never produced any such report. What’s more, its research shows that condoms do work! [5]

Mr. Tobias and others in the administration often cite Uganda as a place where AIDS transmission was reduced by teaching youth to be abstinent. But Ugandans themselves - and objective researchers - say that condom use plays a big role.

Beatrice Wear of ActionAid who works in the Ugandan capital, Kampala, says that the American evangelical right’s interference “flies in the face of 20 years’ experience of what works”. She condemns them for “exporting to Africa an aggressive and highly moralistic HIV prevention approach based on abstinence and fidelity” which simply does not work. She explains:
US Aids funding sounds impressive: $15bn over five years. But its prevention approach of restricting condom distribution to so-called ‘high risk’ groups such as commercial sex workers and truck drivers, ignores the reality of the African epidemic, which is young and female. It assumes African women possess a level of control over their lives and sexuality that they often do not. [6]
Let us not forget that the US is the principal worldwide source of funding.

The New York Times noted:
In Zambia and Brazil, condom use has also reduced AIDS transmission, but administration officials do not talk about these countries. They have removed information about condom use and references to the value of sex education and condom promotion from the Web sites of the Centers for Disease Control and Prevention and the Agency for International Development. Their benighted policies put millions at risk.[7]

As a footnote, I should add, that I don’t doubt Mr Tobias’s credentials as an expert on either condoms or abstinence, or for that matter the funding of projects relating to sexual practice. Readers of the New York Times may recall reports last year of him being forced to resign after it was revealed he was a valued regular customer at a $300 per hour Washington DC brothel! [8]
The policies may be ‘benighted’ but they are proposed by men like Tobias, who demands from others the sort of sexual self-control of which he himself is clearly incapable.

In consequence, agencies fighting the epidemic are now hamstrung by counter-productive conditions of US funding. This has been, as a Rolling Stone magazine editorial put it, “An Epidemic Failure”. Geraldine Sealy, writing for the magazine drove the point home when she said:
In addition to shortchanging international relief efforts, Bush is using AIDS funds to place religion over science, promoting abstinence and monogamy over more effective measures such as condoms and sex education. Before overseas groups can receive U.S. funding, for example, the Bush administration requires them to take a "loyalty oath" to condemn prostitution -- a provision that AIDS workers say further stigmatizes a population in need of HIV education and treatment. [9]

The Bush administration’s stance is backed by the Catholic Church. The United Nations AIDS organizations UNAIDS has stated emphatically that such a stance has had terrible consequences globally: “The rapid spread in Latin America of the virus that causes AIDS is made worse by the Roman Catholic Church's stand against using condoms”.

UNAIDS Coordinator for Honduras, Nicaragua and Costa Rica, Alberto Stella, put it plainly:
"In Latin America, the use of condoms has been demonized, but if they were used in every relation I guarantee the epidemic would be resolved in the region. The fact [that] young people start to be sexually active between 15 and 19 without sex education contributes to the spreading of the virus, as well as the fact that the evidence shows abstinence is not working.” [10]

UNAIDS is emphatic that – apart from abstinence, which is obviously impractical –“Quality-assured male and female condoms are the only products currently available to protect against STIs, including HIV. When used properly every time one has sex, condoms are a proven and effective means of preventing HIV infection in women and men.” [11]

My favorite quote on condoms comes from a former U.S. Surgeon General: “We all know the vows of abstinence break far more easily than latex condoms [12]

We often hear that HIV/Aids is spread primarily by having unprotected, non-monogamous sexual relations, and that since the Catholic Church does not encourage such behaviour, it cannot be blamed for contributing to the spread of the epidemic. But this is sophistry. It’s like saying reckless driving causes automobile accidents. While this is true, it doesn’t mean one ought to campaign against seat belts or crash helmets, or campaign – unrealistically - for people to stay home and never travel.
Like travel, sex is a fact of life – a daily fact of life for millions around the world. Like seatbelts don’t necessarily make safer drivers, they do save lives – and so do condoms.

UNAIDS is crystal clear that condoms have played “a decisive role” in combating AIDS and it acknowledges the condom as, quote “the most efficient and available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.” Unquote [13]

And no sane person could doubt it. No person of goodwill, unhitched of religious dogma, could fail to understand this fact.
Human Rights Watch (HRW) has noted that the Roman Catholic Church, in particular, colludes with and bolsters the pseudo-science peddled by the religious right in the United States. It says:
“As in the United States, condom opponents within the Roman Catholic church have at times made false scientific claims about condoms in order to buttress their moral arguments.” [14]

“At times made false scientific claims”? I understand, ladies and gentlemen, that Human Rights Watch has to be diplomatic, but I feel we here today can be more straightforward: Not content with moral posturing, both the Vatican and the Religious Right obscure the nature of their mad doctrines with a dangerous blizzard of lies.

And could any lie have been more pernicious – more murderous – than this one: In 2003, the president of the Vatican's Pontifical Council for the Family, Cardinal Alfonso Lopez Trujillo claimed that the Aids virus is roughly 450 times smaller than the spermatozoon – a sperm cell - and thus can easily pass through the 'net' that is formed by the condom. [15]

Over four continents they spread this balderdash, in spite of clear scientific and empirical evidence to the contrary!
Sickeningly, the Vatican , does not let its complicit role stop it from crying crocodile tears for the victims. On World Aids Day in 2005, for example, Pope Ratzinger said he felt “close to the victims of AIDS”. [16]

It is important to remember that most AIDS prevention strategies never advocated unbridled sexual behavior to begin with. Most put ‘abstinence’ first – the Abstinence, Be faithful and Condoms approach to reducing HIV infection risk: the so-called A-B-C. [17]
In part, this should have been a sensible compromise between the realistic and the religious camps. But fundamentalism isn’t called fundamentalism for nothing, and a compromise with religious dogma isn’t that easy to achieve. More and more pressure is being applied to drop the “C” altogether.

Once again, the religious lobbies in the US have had a devastating impact on the practical side of prevention strategies in Africa. An anonymous representative of the US-funded HIV/AIDS organization based in Kampala said:“A year ago, ABC was still cool in Uganda. Now, C is out of the equation.” [18]

This representative had to be anonymous because any public criticism of this insanity might jeopardise their limited funding, which, while having many strings attached, is funding nonetheless. And desperately needed.

According to Human Rights Watch, many of these organisations fear that if they promote condoms too loudly, they will risk being denied access by local governments too. [19]

Headlines like that in the Boston Globe “Faith groups urge cuts to AIDS fund” [20] must have a profound impact on the confidence and security these groups need to do their important work.

But UNAIDS flags up yet another chilling reality. They point out
“Due to gender norms and inequalities, young girls and women are regularly and repeatedly denied information about, and access to, condoms, and often they do not have the power to negotiate the use of condoms.” [21]

This observation by UNAIDS researchers was emphasized in a speech by its director, Peter Piot in December 2006. Piot stated that the key drivers of this epidemic were “gender inequality, stigma and discrimination, deprivation and the failure to protect and realize human rights”. [22]

In the most at-risk societies, it is undeniable that these “gender norms and inequalities” are enforced and perpetuated by conservative religious leaders.

But lest we get the impression that it is only Christian fundamentalists in Rome and the Bible Belt behind this, it is now increasingly clear that the Vatican has been joined by Islamic leaders in condemning condom use. For example, in Kenya, a Muslim leader stated:
“A lot of money is being wasted to poison our community … a huge amount of money is spent on buying condoms, buying immorality.” [23]

In Malaysia, Muslim clerics have strongly criticized a government plan to distribute condoms, saying that it would encourage extra-marital sex and that it violated Islamic law.[24]

Chillingly, some Islamic countries – in particular – criminalise those infected with HIV.[25]

Another tragic irony is that it is the same conservative religious forces that undermine efforts to educate at-risk groups about condoms are often the same that perpetuate other abuses of human rights. And it is these human rights deficiencies that UNAIDS director Peter Piot identifies as a prime driver in the spread of HIV/AIDS.

The lethal ingredients in the cocktail that conspires to thwart successful AIDS prevention programmes are:
a) The disproportionate religious influence on Western governments that are providing funding
b) the religious nature of many of the charities working in the field, and
c) the conservative local traditions of many areas most affected by HIV.

Together they result in a ghastly human tragedy on an enormous scale, but a preventable one.
The situation was best summed up by Don Baxter, Executive Director of the Australian Federation of AIDS Organisations when he said:
"Political interventions by a range of governments, particularly by the US and by members of the Organisation of Islamic [Conference] Countries – sometimes all in unholy alliance with the Holy See – lead to compromises and confusing language which will undermine the necessary focus on the populations where most HIV infections are occurring." [26]

Of the estimated 40 million people worldwide infected with HIV, almost two-thirds are in sub-Saharan Africa. [27] And the lives of many more are devastated by the disease, the families - those economically and emotionally dependent - on those infected. [28] The health workers in these countries are in the front line of the fight against the epidemic. They need to be listened to, not archbishops, preachers and mullahs.

This speech is based on evidence the (UK) National Secular Society submitted to a Parliamentary Committee considering the effectiveness of funding for disease control programmes. We understand that the Committee declined calls from some of its own members to call on the Catholic Church to be cross examined as a witness. Our evidence has been circulated to all members of the Committee, exposing them to the unvarnished truth, however painful they may find it.

You are welcome use this material as a resource for your own campaigning.

I conclude by asking you all to take every opportunity to spread awareness in your own national media about this terrible but preventable suffering and lobby your politicians to press for counter-measures to be based on evidence rather than on blind religious dogma.
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This material can also be reproduced in whole or part without permission for your own magazines or other media, providing the (UK) National Secular Society is given as the source and our website www.secularism.org.uk is mentioned.

1. www.whrnet.org/fundamentalisms/docs/issue-gluttons-0706.html
2. ibid
3. http://query.nytimes.com/gst/fullpage.html?res=9902E0DD153FF93BA25756C0A9629C8B63
4. ibid
5. ibid
6. NSS Newsline 9 December 2005
7. http://query.nytimes.com/gst/fullpage.html?res=9902E0DD153FF93BA25756C0A9629C8B63
8. www.nytimes.com/2007/05/01/washington/01madam.html?n=Top/Reference/Times%20Topics/People/L/Lewis,%20Neil%20A.
9. www.rollingstone.com/politics/story/7371950/an_epidemic_failure/
10. www.reuters.com/article/healthNews/idUSN2222015720071023
11. www.unaids.org/en/KnowledgeCentre/Resources/FastFacts/default.asp
12. Former U.S. Surgeon General Joycelyn M. Elders [link www.rethinkingschools.org/sex/elders.shtml[/link]
13. www.unaids.org/en/KnowledgeCentre/Resources/FastFacts/default.asp
14. www.hrw.org/backgrounder/hivaids/condoms1204/3.htm
15. www.guardian.co.uk/world/2003/oct/09/aids
16. http://blogs.reuters.com/faithworld/2007/11/30/pope-skirts-condoms-issue-in-world-aids-day-statement/
17. www.avert.org/abc-hiv.htm
18. www.hrw.org/reports/2005/uganda0305/7.htm
19. ibid
20. www.boston.com/news/nation/articles/2006/12/01/faith_groups_urge_cuts_to_aids_fund/
21. www.unaids.org/en/PolicyAndPractice/Prevention/Condoms/default.asp
22. www.unaids.org/en/PolicyAndPractice/DriversOfTheEpidemic/default.asp
23. http://wluml.org/english/newsfulltxt.shtml?cmd%5B157%5D=x-157-561599
24. www.iht.com/articles/2005/07/03/news/malay.php
25. http://hrw.org/english/docs/2008/04/07/egypt18438.htm
26. www.afao.org.au/view_articles.asp?pxa=ve&pxs=86&id=539
27. http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH02_en.pdf
28. www.avert.org/aidsimpact.htm

June 09 2008

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